Surgical Management of Malignant Pleural Mesothelioma: Impact of Surgery on Survival and Quality of Life—Relation to Chemotherapy, Radiotherapy, and Alternative Therapies

We reviewed abstracts from the recent European Association of Cardiothoracic Surgery meetings and I searched the British Thoracic Society website for relevant material

Sotiris Papaspyros

2014

Scholarcy highlights

  • Malignant pleural mesothelioma is an aggressive cancer arising from pleural mesothelium
  • Eligible studies for the present review included those in which patients with histologically proven MPM were treated with surgery either as the only treatment or as part of a protocol involving adjuvant or neoadjuvant chemotherapy and/or radiotherapy
  • The first was published by Cao et al and they reviewed the role of extrapleural pneumonectomy in the management of MPP. We reviewed their references and included some of the studies that were relevant to my systematic review
  • A large proportion of patients were referred to their hospitals for enrolment into the mesothelioma and radical surgery trial involving EPP during the 2005– 2008 period
  • Treasure et al embarked in a very ambitious project in 2005 to conduct a randomised controlled trial across 12 centres in the UK, which would definitively determine the role of EPP in the management of mesothelioma in the context of trimodality treatment
  • This systematic review has shown that EPP and P/D for patients with MPM can be performed with an acceptable perioperative mortality rate in specialised centres
  • These encouraging results demonstrate the potential benefit that surgery can offer for patients treated by a multidisciplinary approach in specialist high volume centres

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